Volume 6, Issue 3, June 2018, Page: 61-67
Long-Term Effects of Bariatric Surgery on Health-Related Quality of Life: A Systematic Review
Roberta Sônia Rodrigues Álvares, Medicine Department, Federal University of Minas Gerais, Belo Horizonte, Brazil
Maria de Fátima Haueisen Sander Diniz, Medicine Department, Federal University of Minas Gerais, Belo Horizonte, Brazil
Ana Luisa Bagno de Almeida, Medicine Department, Federal University of Minas Gerais, Belo Horizonte, Brazil
Matheus Nagib Lemos Paulo, Medicine Department, Federal University of Minas Gerais, Belo Horizonte, Brazil
Alline Maria Rezende Beleigoli, Medicine Department, Federal University of Minas Gerais, Belo Horizonte, Brazil
Received: Mar. 12, 2018;       Accepted: Apr. 8, 2018;       Published: May 9, 2018
DOI: 10.11648/j.js.20180603.12      View  1260      Downloads  85
Introduction: Obese patients who seek bariatric surgery (BS) have great impairment in health-related quality of life (HRQoL). Along with weight loss, BS leads to improvement in HRQoL in the short-term. However, physical, psychological and social issues that ensue after BS might impact on HRQoL in the long-term. The aim was to systematically review the literature in order to explore the impact of bariatric surgery on HRQoL of severely obese patients in the long-term. Methods: Electronic databases were searched (Pubmed/Medline, Lilacs, IBECS, Cochrane Library, SciELO) to retrieve studies of adults with BMI≥35kg/m² which assessed HRQoL five or more years after BS. Hand search of references of previous reviews was also performed. GRADE was used to assess the quality of the evidence. Results: Of the 1226 articles retrieved, nine longitudinal studies were selected. A total of 4031 patients were followed-up. Female sex was predominant in all studies. Only one study did not find improvement in HRQoL after BS. Improvement of physical aspects of HRQoL was more commonly reported than mental aspects. The quality of the evidence retrieved was rated as low mainly due to the lack of adjustment for prognostic factors that might have led to counfounding in the assessment of HRQoL and under-report of follow-up rates. Differences in the instruments to assess HRQoL and in the composition of control groups among the studies did not allow to perform meta-analysis. Conclusion: BS was associated with improvement in HRQoL in the long-term, particularly in physical aspects. The low quality of the studies selected points out to the need of controlled trials to better assess the long-term effects of BS on HRQoL.
Quality of Life, Health-Related Quality of Life, Bariatric Surgery, Long-Term Effects
To cite this article
Roberta Sônia Rodrigues Álvares, Maria de Fátima Haueisen Sander Diniz, Ana Luisa Bagno de Almeida, Matheus Nagib Lemos Paulo, Alline Maria Rezende Beleigoli, Long-Term Effects of Bariatric Surgery on Health-Related Quality of Life: A Systematic Review, Journal of Surgery. Vol. 6, No. 3, 2018, pp. 61-67. doi: 10.11648/j.js.20180603.12
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Raoof M, Näslund I, Rask E, Karlsson J, Sundbom M, Edholm D, et al. Health-Related Quality-of-Life (HRQoL) on an Average of 12 Years After Gastric Bypass Surgery. Obes Surg. 2015; 25 (7):1119–27.
Picot J, Jones J, Colquitt JL, Gospodarevskaya E, Loveman E, Baxter L, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Heal Technol Assess. 2009; 13 (41):1–190, 215–357.
Costa RCN, Yamaguchi N, Santo MA, Riccioppo D, Pinto-Junior PE. Outcomes on Quality of Life, Weight Loss, and Comorbidities After Roux-En-Y Gastric Bypass. Arq Gastroenterol. 2014; 51 (3):165–70.
Sarwer DB, Spitzer JC, Wadden TA, Rosen RC, Mitchell JE, Lancaster K, et al. Sexual functioning and sex hormones in persons with extreme obesity and seeking surgical and nonsurgical weight loss. Surg Obes Relat Dis. 2013; 9 (6):997–1007.
Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, et al. Bariatric surgery. A Systematic Review and Meta-analysis. JAMA. 2004; 292 (14):1724–37.
Mancini MC. Bariatric surgery – An update for the endocrinologist. Arq Bras Endocrinol Metab. 2014; 58 (9):875-88.
Ahmad A, Laverty AA, Aasheim E, Majeed A, Millett C, Saxena S. Eligibility for bariatric surgery among adults in England: analysis of a national cross-sectional survey. JRSM Short Rep. 2013; 5 (1):1–6.
Gould JC, Beverstein G, Reinhardt S, Garren MJ. Impact of routine and long-term follow-up on weight loss after laparoscopic gastric bypass. Surg Obes Relat Dis. 2007; 3 (6):627–30.
Mechanick JI, Youdim A, Jones DB, Timothy Garvey W, Hurley DL, Molly McMahon M, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update. Surg Obes Relat Dis. 2013; 9 (2):159–91.
Fried M, Hainer V, Basdevant A, Buchwald H, Deitel M, Finer N, et al. Interdisciplinary European guidelines for surgery for severe (morbid) obesity. Vol. 17, Obesity Surgery. 2007. p. 260–70.
Oria HE, Moorehead MK. Updated Bariatric Analysis and Reporting Outcome System (BAROS). Surg Obes Relat Dis. 2009; 5 (1):60–6.
WHOQOL Group. What quality of life? The WHOQOL Group. World Health Organization Quality of Life Assessment. World Health Forum. 1996; 17 (4):354–6.
Centers for Disease Control and Prevention. Measuring healthy days. Population Assessment of Health-Related Quality of Life. Health Care. 2000. 1-40 p.
Selim AJ, Rogers W, Fleishman JA, Qian SX, Fincke BG, Rothendler JA, et al. Updated U.S. population standard for the Veterans RAND 12-item Health Survey (VR-12). Qual Life Res. 2009; 18 (1):43–52.
Risstad H, Sovik TT, Hewitt S, Kristinsson JA, Fagerland MW, Bernklev T, et al. Changes in Health-Related Quality of Life After Gastric Bypass in Patients With and Without Obesity-Related Disease. Obes Surg. 2015; 25 (12):2408-16.
Oh SH, Song HJ, Kwon JW, Park DJ, Lee YJ, Chun H, et al. The improvement of quality of life in patients treated with bariatric surgery in Korea. J Korean Surg Soc. 2013; 84 (3):131–9.
Dziurowicz-Kozlowska A, Lisik W, Wierzbicki Z, Kosieradzki M. Health-related quality of life after the surgical treatment of obesity. J Physiol Pharmacol. 2005; 56 (Suppl 6):127–34.
Hachem A, Brennan L. Quality of Life Outcomes of Bariatric Surgery: A Systematic Review. Obes Surg. 2016; 26 (2):395-409.
Bocchieri LE, Meana M, Fisher BL. Perceived psychosocial outcomes of gastric bypass surgery: A qualitative study. Obes Surg. 2002; 12 (6):781–8.
De Zwaan M, Lancaster KL, Mitchell JE, Howell LM, Monson N, Roerig JL, et al. Health-related quality of life in morbidly obese patients: Effect of gastric bypass surgery. Obes Surg. 2002; 12 (6):773–80.
Adams TD, Davidson LE, Litwin SE, Kolotkin RL, LaMonte MJ, Pendleton RC, et al. Health Benefits of Gastric Bypass Surgery after 6 years. JAMA. 2012; 308 (11):1122-31.
Guyatt GH, Oxman AD, Vist G, Kunz R, Brozek J, Alonso-Coelho P, et al. GRADE guidelines: 4. Rating the quality of evidence - Study limitations (risk of bias). J Clin Epidemiol. 2011; 64 (4):407–15.
Velcu LM, Adolphine R, Mourelo R, Cottam DR, Angus LDG. Weight loss, quality of life and employment status after Roux-en-Y gastric bypass: 5-year analysis. Surg Obes Relat Dis. 2005; 1 (4):413–6.
Suter M, Donadini A, Romy S, Demartines N, Giusti V. Laparoscopic Roux-en-Y gastric bypass: significant long-term weight loss, improvement of obesity-related comorbidities and quality of life. Ann Surg. 2011; 254 (2):267–73.
Kalfarentzos F, Kechagias I, Soulikia K, Loukidi A, Mead N. Weight loss following vertical banded gastroplasty: Intermediate results of a prospective study. Obes Surg. 2001; 11 (3):265–70.
Aftab H, Risstad H, Søvik TT, Tomm Bernklev PD, Hewitt S, Kristinsson JA, et al. Five-year outcome after gastric bypass for morbid obesity in a Norwegian cohort. Surg Obes Relat Dis. 2014; 10 (1):71–8.
García AMA, Márquez MF, Carreño TP, Alcaraz Garcia AM, Ferrer Marquez M, Parron Carreno T. Quality of life in obese patients and change after bariatric surgery medium and long term. Nutr Hosp. 2015; 31 (5):2033–46.
Weiner R, Blanco-Engert R, Weiner S, Matkowitz R, Schaefer L, Pomhoff I. Outcome after Laparoscopic Adjustable Gastric Banding – 8 Years Experience. Obes Surg. 2003; 13 (3):427–34.
Pasnik K, Krupa J, Stanowski E. Vertical banded gastroplasty: 6 years experience at a center in Poland. Obes Surg. 2005; 15 (2):223–7.
Karlsson J, Taft C, Rydén A, Sjostrom L, Sullivan M. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. Int J Obes (Lond). 2007; 31 (8):1248–61.
Lindekilde N, Gladstone BP, Lubeck M, Nielsen J, Clausen L, Vach W, et al. The impact of bariatric surgery on quality of life: a systematic review and meta-analysis. Obes Rev. 2015; 16 (8):639–51.
Jumbe S, Bartlett C, Jumbe SL, Meyrick J. The effectiveness of bariatric surgery on long term psychosocial quality of life – A sistematic review. Surg Obes Relat Dis. 2016; 10 (3):225-42.
Andersen JR, Aasprang A, Karlsen T-I, Karin Natvig G, Våge V, Kolotkin RL. Health-related quality of life after bariatric surgery: a systematic review of prospective long-term studies. Surg Obes Relat Dis. 2015; 11 (2):466–73.
Ballantyne GH. Measuring Outcomes following Bariatric Surgery: Weight Loss Parameters, Improvement in Co-morbid Conditions, Change in Quality of Life and Patient Satisfaction. Obes Surg. 2003; 13 (6):954–64.
Oria HE, Moorehead MK. Bariatric Analyses and Reporting Outcome System (BAROS). Obes Surg. 1998; 8:487-99.
Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 Health Survey Manual and Interpretation Guide. Bost New Engl Med Cent. 1993; 1 v. (various pagings).
O’Brien PE, Dixon JB, Brown W, Schachter LM, Chapman L, Burn AJ, et al. The laparoscopic adjustable gastric band (Lap-Band?): A prospective study of medium-term effects on weight, health and quality of life. Obes Surg. 2002; 12 (5):652–60.
Khawali C, Ferraz MB, Zanella MT, Ferreira SRG. Evaluation of quality of life in severely obese patients after bariatric surgery carried out in the public healthcare system. Arq Bras Endocrinol Metab. 2012; 56 (1):33–8.
Browse journals by subject